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Application Organization (AO) Process for Annual Renewal

AO Annual Renewal Process (3 Steps)

Appplication Organization (AO) registration is valid for one (1) year and must be renewed each year. The annual renewal requirements for AOs consists of Steps 1-3 below. All AOs must complete the annual renewal requirements by no later that the last day of the anniversary month of their original registration approval date. So, for example, if an organization was originally registered as an AO on August 19, 2013, that organization must complete all renewal requirements by no later than August 31st of each proceeding year. Renewed AO licenses may be printed online at www.sircon.com/indiana by selecting "Print a License."

The annual renewal process consists of the following three steps:

ONLINE RENEWAL APPLICATION. Complete theonline renewal application via Sircon.com (AOs complete the "Firm" renewal application). There is a nonrefundable online renewal application fee of $50 for Indiana resident business entities and $100 for non-resident business entities, and a processing fee. NOTE: Additional documentation required in Steps 2 and 3 may be attached electronically to the renewal application. AOs may check the status of their renewal application at www.sircon.com/indiana by selecting "Check license renewal status."

Sixty (60) days prior to the renewal deadline, AOs will be sent a courtesy email reminder to their business email notifying them of the requirement to renew. If the reminder email is not received for any reason, it is still the AO's responsibility to renew the registration. Online renewal applications CANNOT be submitted more than sixty (60) days prior to an AO's registration expiration date.

Note: There is a 30-day late period in which AO renewal applications may be submitted. If a renewal application is submitted 1-30 days after the AO registration expiration date, a late fee of three (3) times the renewal application fee will be applied in addition to the renewal fee. AOs that fail to renew within the late period are required to complete each of the initial AO application steps again in order to reactivate the registration.

LIST OF AO LOCATIONS. If the AO has more than one AO location, it must submit to IDOI the following for each location of the AO: (1) Name, (2) Address, (3) Telephone, (4) Email, (5) Website (if applicable), and (6) Contact Person. The list may be attached electronically to the online renewal application. The AO may also include on the list all Indiana counties a particular location services, if the location services one or more counties outside of its location. The list will be used to publish available AO assistance by county on the Indiana Healthcare Reform website at www.in.gov/healthcarereform/2468.htm.

CONFLICT OF INTEREST DISCLOSURE FORM. If the AO has an actual or potential Conflict of Interest (as defined by the Conflict of Interest Policy) that has not been previously disclosed to IDOI, the AO must submit to IDOI the AO Conflict of Interest Disclosure Form disclosing the Conflict of Interest. The form may be attached electronically to the online renewal application.

All documents may be attached electronically to the online renewal application. Documents may also be submitted to IDOI by either: Email: navigator@idoi.in.gov;Fax: 317-234-5882 ("attn: Navigator Director"); or Mail: Indiana Department of Insurance, c/o Navigator Director, 311 West Washington Street, Indianapolis, Indiana 46204-2787